The goal of this doctoral research training program is to understand how pediatric intensive care unit (PICU) nurses care for dying children and their families. The specific aims are: 1) to describe PICU nurses' perceptions, beliefs, and attitudes toward palliative care in the intensive care unit; 2) to describe PICU nurses' competence and comfort in delivering palliative care; 3) to investigate the resources and support available to PICU nurses in providing care for dying children and their families; and 4) to describe how palliative nursing care is delivered in the PICU. Grounded theory research methods will be used to achieve these aims. Open-ended interviews and participant observation during clinical practice will be conducted with nurses from a single PICU, allowing for in-depth analysis of the roles that both individual and environmental factors play in the delivery of end-of-life care to children and families in the PICU. Audio- recordings of the interviews and field notes from observations will allow for analysis of themes and the development of a theoretical model that describes PICU nurses' work with dying children and their families.